The National Maternity and Perinatal Audit (NMPA) has published its second organisational report which maps services, staffing and facilities across all hospital trusts and health boards as of January 2019.
The report shows how maternity and neonatal services have changed since the last survey in January 2017. It also outlines where these services have improved and where further work is needed to meet national guidance and recommendations.
All 151 eligible trusts and health boards that provide on-site care for women during pregnancy and childbirth in Britain were included in the audit. In total, 130 trusts in England, 14 boards in Scotland, and 7 boards in Wales took part.
The key findings include:
- Smoking cessation and weight management support is available at 72% and 45% of trusts and health boards respectively – no improvement since 2017.
- A higher number of trusts and health boards participate in a perinatal mental health network – this has increased from 70% to 93% in England, from 43% to 79% in Scotland, and from 71% to 86% in Wales.
- Access to community perinatal mental health teams increased from 72% to 91% of trusts and boards, and to specialist perinatal mental health midwives from 72% to 91% of 151 trusts and boards. Availability of psychiatrist clinics increased from 37% to 58% of maternity sites with an obstetric unit.
- 83% of maternity sites with a neonatal unit provided transitional care – keeping mothers and babies together and avoiding unnecessary neonatal unit admission – and this has risen from 64% in 2017.
- Maternity sites with a dedicated multi-disciplinary cardiac clinic increased from 18% to 25%, with a greater geographical spread in England and Scotland than in 2017.
- Access to electronic maternity records improved for community midwives, with 66% of trusts and boards reporting access at any location and 90% at midwives’ community bases. But still only 19% reported that women could access their own electronic record, and the number of GPs with access decreased from 29% to 21%.
- While 87% of obstetric units reported gaps in their obstetric middle grade rotas, compared to 89% in 2017, the number that required locum cover remained the same at 83%.
- 85% of sites reported that at least 95% of women had one-to-one midwifery care in established labour, compared to 84% in 2017. But only half (51%) of maternity sites reported that all women received one-to-one care in established labour, compared to 54% in 2017.
The report also provides a breakdown of birth settings, such as obstetric units co-located with an alongside midwifery unit, and facilities such as private bathrooms, available to women and their families.
Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists, said:
“With more than one in 10 women experiencing mental health problems during pregnancy and in the post-natal period, it is highly encouraging to see a significant increase in women being able to access to specialist mental health services.
“However, it is extremely disappointing to see no improvement in accessibility to specialist services on weight management and smoking cessation. Funding cuts to local public health budgets are unacceptable and investment in these services will not only support women to be as healthy as possible before, during and after pregnancy, but give their babies the best possible start in life, and save money in the long term by preventing future health problems.
“We are also disappointed that only one in five pregnant women have access to their electronic maternity records. This is a backwards step and Trusts must take steps to address this urgently and give more women autonomy over their own healthcare.
“The report highlights that workforce challenges persist among the obstetrics and gynaecology profession, while demands on maternity and neonatal services grow. We hope the findings from this latest report will help to ensure the workforce is equipped and supported to deliver the highest levels of care to women and their families across the country.”